This research will be done primarily in Ecuador as an extension of NIA grant 1 R01 AG13975, May 1997- April 2003 "Vitamin E and Infection in the Elderly." The overall goal of the parent grant is to determine the role of nutrients on immune response and resistance to infectious diseases in the elderly. Specifically, the objectives include evaluations of the effect of one year supplementation with vitamin E on: 1) incidence of respiratory infections (RI), total number of sick days, and antibiotic use, 2) in vivo and in vitro indices of cell-mediated and humoral immune responses, and 3) incidence of other infections, hospitalization, transfer to skilled nursing home facilities, and death. We intend to expand the goals of this grant by determining the relationship between nutritional status, immune response and health status in Ecuadorian elderly. In so doing, we will in part utilize the infrastructure of a related NIH grant, 1 R01HD 38327-0 1 A1, "Vitamin A and Zinc: Prevention of Pneumonia (VAZPOP) Study, Jan 2000-Dec 2004. This latter project is studying the potential benefits of vitamin A and/or zinc for the prevention of pneumonia and diarrheal diseases in malnourished children in Ecuador. The number of elderly is increasing both in developed and developing countries. Age-associated physiological, psychological, social, and economic changes adversely affect the nutritional and immunological status of older individuals. These changes are often reflected in poor health and a reduced quality of life. Infections, particularly respiratory infections, are prevalent in the elderly, and contribute significantly to their morbidity and mortality as well as to the associated costs of heath care. Micronutrient supplementation has been proposed as a cost-effective intervention to improve immune response and reduce morbidity and mortality in the elderly. Because of the higher prevalence of nutritional deficiencies and infectious diseases in developing countries such as Ecuador, the interaction between nutrition, immune response, and infectious diseases can be more efficaciously determined in these countries. Such information would be of great value to developing countries, because, despite the increasing number of elderly in these countries, very little is known about the nutritional and immunological status of their elderly and their impact on the health of the older population. Thus the specific aim of this proposal is to determine the nutritional, immunological, and health status of the elderly population living in the VAZPOP study area (poor northwestern suburb) of Quito. Nutritional status will be assessed by obtaining dietary intake, selected nutrient analysis, and anthropometrics measurements. Immunological status will be assessed using delayed type hypersensitivity skin test (DTH), cellular profile, and a whole blood assay to determine lymphocyte proliferation and selected cytokine production. Health status will be determined using health questionnaires.